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The researchers found that clinical rotation at a primary care HIV clinic, coupled with a specially curated curriculum, increased medical students – and even internal medicine residents – interest in a career in infectious diseases.
According to the results of a study published in the Open Forum Infectious Diseases, their knowledge of HIV and STI management has also improved.
Darcy Wooten
“There are fewer trainees working in the field of infectious diseases. There are several reasons for that. ” Darcy Wooten MD, MS, said Healio, associate associate professor of medicine at the University of California at San Diego’s School of Medicine (UCSD) and associate program director of the UCSD ID Fellowship Training Program.
Wooten said previous research has shown that trainees who have had positive clinical, research, and mentoring experiences early in their careers, such as during medical school and residency, are more likely to pursue ID than if they did not have those experiences .
“In addition, the skills required to provide culturally competent, trauma-related care of inquiries on sensitive topics such as the recording of a sexual history and the history of mental health and substance use are critical to all care providers regardless of specialty.” said Wooten. “Primary HIV Care Clinics provide a unique educational environment to provide clinical opportunities for students and residents to practice these skills with experienced providers.”
Wooten and colleagues created a curriculum for trainees who switch to their HIV clinic to assess whether the trainees’ skills in dealing with HIV and STDs, their confidence and their ability to have a culturally literate sex history, and influences their interest in a career in ID or HIV.
“This is becoming increasingly important as the US continues to lack HIV and ID providers and we need more providers if we are to end the HIV epidemic,” she said.
As part of the curriculum, third-year medical students and sophomore internal medicine students participated in an elective rotation for 2 to 4 weeks at UCSD’s HIV primary care clinic, which provides 3,014 patients with primary and sub-special care HIV, explained Wooten and colleagues .
A total of 31 trainees took part in the rotation during the 6-month study and 21 completed the survey before and after the rotation. Residents and medical students made up 57% (12) and 43% (9) of the cohort, respectively.
According to the study, knowledge of ART management, treatment as prevention, and STI management improved after rotation, with the greatest improvements being seen in recommending ART therapies of first choice. Knowledge of treating gonorrhea and syphilis also improved (85% to 90% and 43% to 48%, respectively), Wooten and colleagues reported.
According to the study, residents had a higher level of basic knowledge about first-line ARV therapies, STI screening, and syphilis treatment, while students had a higher level of basic knowledge about treatment than prevention and gonorrhea treatment. Student outcomes improved more on STI screening and gonorrhea treatment, while resident outcomes improved more on first-line ART therapies, treatment as prevention, and syphilis treatment.
Overall, the trainees said they had improved their clinical skills to medically treat people with HIV (24% to 90%) and to maintain a culturally competent sex history (57% to 100%) and an increased interest in an ID career (24)% to 71%) a change after the rotation that was mostly driven by medical students, said Wooten and colleagues.
“Robust training programs in HIV clinics have the potential to provide trainees with core knowledge and skills that are important to all future physicians and increase interest in trainees pursuing careers in ID or HIV,” said Wooten.
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